Stricter glycemic control during short-term intensive insulin therapy produced more remission despite self-manageable hypoglycemia. Based on glycemic parameters in the middle mean tertile, we propose new glycemic targets that are about 0.4mmol/L lower than current ones as long-term benefit outweighs short-term risks (Journal of Diabetes Investigation)

Personalized treatment in older people with type 2 diabetes is no common practice. A substantial number of older people are overtreated, with likely harmful consequences. To prevent overtreatment, definition of lower HbA1C limits might be helpful (Diabetes, Obesity and Metabolism)

The pattern of mortality risk across levels of HbA1c differed by glucose-lowering regimen. Lower HbA1c was associated with increased mortality risk compared with moderate control, especially in those regimens associated with hypoglycaemia. High levels of HbA1c were associated with the expected elevated mortality risk in regimens with low hypoglycaemia risk (Diabetes, Obesity and Metabolism)

If the HbA1c achievement rates in service provision, medication and use of technology currently seen in practices in the 90th percentile were to be matched with regard to HbA1c achievement rates in all general practices, glycaemic control might be improved for 36 500 people, with all the attendant health benefits (Diabetic Medicine)

Treatment with VitD was associated with an improvement in EF and reduced expression of urinary inflammatory markers in adolescents with T1D. This data is suggestive of an additional benefit of VitD supplementation on early markers of microvascular complications (Pediatric Diabetes)

Patients with T2DM have an increased risk of fragility fractures, which was not predictable by BMD measurements. This higher risk is probably multifactorial, and antidiabetic therapies may have an impact on bone metabolism (Diabetology & Metabolic Syndrome)

The morbidity and mortality associated with nocturnal hypoglycaemia is probably much greater than realised, causing seizures, coma and cardiovascular events and affects quality of life, mood and work performance the following day (Diabetes Research and Clinical Practice)

Among adults with type 2 diabetes diagnosed for less than 10 years, a lifestyle intervention compared with standard care resulted in a change in glycemic control that did not reach the criterion for equivalence, but was in a direction consistent with benefit. Further research is needed to assess superiority, as well as generalizability and durability of findings )JAMA)

US patients with T2D who experienced hypoglycemia within 6 months of basal insulin initiation were more likely to discontinue treatment, accompanied by a greater healthcare burden (Advances in Therapy)

A number of factors including diabetes education, perceived and actual hyperglycaemia and macrovascular complications are associated with treatment satisfaction. Self-management education programmes should incorporate these factors for ongoing support in patients with T2DM (BMJ Open)

Prescribing for Diabetes reports on and examines prescribing trends on medicines prescribed in primary care in England for the treatment and monitoring of diabetes during the period April 2006 to March 2017 (NHS Digital)

Simply increasing use of insulin pumps may increase resource costs without seeing improvements to diabetes control. If after training individuals still find blood glucose control challenging, they could be offered pump treatment in line with NICE guidance to see if this improves quality of life. (NIHR)

Australian study – Stepping Up was associated with improved glycaemic control compared to usual care for 24 months, suggesting that the model facilitated more timely treatment intensification. Ongoing RN-CDE support may be needed to facilitate ongoing treatment intensification (Primary Care Diabetes)

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